A survey published by the Larry A. Green Center and the Primary Care Collective found that telemedicine has been vital to maintaining patient access to services for almost two-thirds of primary care clinicians – and many providers worry what will happen if pre-pandemic regulations are restored.

According to the survey, which drew on answers from 1,263 respondents from nearly every state, the pressures of providing care amidst COVID-19 have continued to weigh heavily on primary care clinicians.  

"Burnout and a sense of hopelessness and compassion fatigue [are] escalating as this next COVID surge continues. We thought there was light at the end of the tunnel once the vaccine was available, but the pandemic continues to escalate," said one clinician in Illinois.  

WHY IT MATTERS

This survey is the thirtieth of its kind since PCC and the Green Center teamed up to better understand the impact of COVID-19 in real time.

This particular round focused on the effect of the Delta surge on patients and providers, and the role virtual care can play in addressing such a burden.  

"COVID has taken a toll on our finances, mental health and physical health in my practice. We are exhausted!" wrote one Idaho-based clinician.

The survey found that telemedicine has helped to maintain patient access to care, despite struggles with resources and capacity.  

Four in 10 respondents say they use telemedicine for at least a fifth of all office visits, and 35% have developed new work roles in the office to meet needs unique to telemedicine.

At the same time, however, 21% have had to pull back on use of telemedicine since payments were reduced. And a quarter worry that fascination with telemedicine will weaken primary care in the long term.  

In general, primary care is facing severe challenges, the survey said. About half of respondents described their pandemic-related strain as severe or near severe, and nearly half personally know clinicians who have retired early or quit.  

Less than 30% said their practice is financially healthy.   

"We are drowning. Primary care is underfunded, overworked, and the burden only grows as more doctors retire [or] go concierge," said a Delaware clinician. "This will only worsen as the pandemic continues, as burnout is reaching new [heights]."  

Vaccine distrust is contributing to these feelings of hopelessness. Even when clinicians are able to change the minds of vaccine-hesitant patients, 80% said COVID-19 vaccination conversations take several minutes – and time is more valuable than ever.  

"Relationships allow me to even have a shot at getting hesitant patients to accept the vaccine. These conversations are exhausting and demoralizing," said a respondent in Wisconsin.  

THE LARGER TREND  

The primary care crisis is certainly not unique to COVID-19, but the pandemic has exacerbated many underlying issues.

In response, innovators are exploring the ways telehealth can help, such as by connecting more patients with clinicians or implementing long-term virtual care tools.

Earlier this summer, the American Board of Telehealth even launched a certificate for virtual primary care, aimed at helping providers develop future virtual health strategies.  

ON THE RECORD  

"Primary care is resilient, but has weakened. Lack of decisive action and support for primary care continues to undermine its ability to meet growing population health needs and safeguard its workforce," said analysts in the PCC/Green Center survey.  

"Public and private payers must continue to support use of telemedicine to maintain patient access and practice capacity for care delivery. Left with the most difficult to vaccinate portion of the population, primary care clinicians must be adequately supported for the resource- and time-intensive process of countering COVID-19 vaccine hesitancy," they added.

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Email: kjercich@himss.org
Healthcare IT News is a HIMSS Media publication.